Concerns Over Sudden Dietary Changes and Substance Use
I find myself in a precarious situation after drastically shifting from an extremely restrictive diet to indulging heavily for the past three days, all while managing my addictions. I am feeling remarkably unwell and experiencing unusual symptoms. Should I reach out to my general practitioner or contact emergency services, or is this issue not pressing? I am a 20-year-old male, standing at 169 cm and weighing 55 kg. Currently, I am prescribed a regimen that includes 5 mg of aripiprazole, 5 mg of bisoprolol, and 4 mg of extended-release melatonin. Additionally, my lifestyle includes smoking, vaping, and a dependence on multiple substances; I am a polysubstance user and rely on benzodiazepines daily, consuming two pressed bars each day. I also take a diet pill daily. My clinical history includes diagnoses of depression, anxiety, borderline personality disorder (BPD), post-traumatic stress disorder (PTSD), autism, tachycardia, and palpitations, along with a restrictive eating disorder and addiction. Previously, I engaged in severe calorie restriction, ignoring dietary guidelines while space out my food intake primarily to avoid calories. This approach involved minimal meals and appetite-suppressing drugs such as ketamine, DXM, and tapentadol, leading to a significant weight drop of 5 kg within only a month. Despite family and friends expressing concern over my appearance, I remained oblivious to how frail and ill I was until reality hit me hard—I could finally see in the mirror just how unwell I had become. The discomfort and bony sensation left me restless, as no amount of repositioning or cushioning could ease my pain. Since late November 2023, I have shockingly lost 44% of my body weight, with 39% of that occurring from January 2024 onward. As my situation progressed, I slipped back into old eating disorder habits, despite a long history—having battled anorexia and bulimia from childhood—yet I have avoided seeking assistance from the NHS since age 15 due to being deemed a healthy BMI at that time, only a kg away from being classified as underweight. I have held onto the notion that I would only pursue help once I reached a state of being underweight to avoid being turned away again. However, after my recent binge eating episodes, I now feel terrible. Just yesterday, I had a reaction to the sun caused by aripiprazole, yet today my outdoor exposure was limited to a quick 10-minute walk to a group event, which I had to leave prematurely after experiencing dizziness, temporary vision loss, and dissociative symptoms making it hard to communicate or coordinate. My body fatigue was overwhelming, feeling as though it could give out at any moment, which heightened my existing cardiac symptoms (breathing issues, palpitations, chest pain, dizziness). I was nauseated, overly salivating, shaky but not in the usual Tourette's manner, and had a headache. Additionally, I’ve noticed an increase in urination, although I attempted to alleviate my discomfort by taking an electrolyte tablet and a nutritional drink prior to my significant symptoms. I have a blood pressure monitor as designated by my GP, yet today’s readings didn’t raise any immediate concerns; I recorded a slight elevation of 126/76 before my group event and a return to more typical values of 114/73 when I got back home, ultimately landing at 109/63 now with a pulse of 82. My blood pressure was generally lower before starting aripiprazole, given my bisoprolol use. Should I be contacting my GP or calling emergency services, or might this simply be a normal reaction to suddenly increasing my dietary intake or the substances I have ingested recently? I’ve been in an addiction cycle since November, worsening over the last couple of months. I have yet to weigh myself as the thought terrifies me. Knowing the number could lead me to unhealthy decisions, either exacerbating my eating issues or reverting back to severe restriction. My push for caloric restriction stems from a traumatic experience in the hospital just over a month or two ago, following a suicide attempt. Time feels indeterminate since I’ve been homeless. For reference, I have maintained a drug diary for the past ten days, detailing various substances consumed: - **March 24:** 7:38 PM - one pressed bar; 8:30 PM - 25 mg promethazine; 8:35 PM - weed; 8:45 PM - 270 mg DXM & 4 mg clonazepam sublingual. - **March 25:** 5 PM - one pressed bar; 8:41 PM - five pressed bars with a double or triple vodka Pepsi Max; 9:20 PM - weed; 9:36 PM - 120 mg freebase DXM, one pressed bar, 2 mg clonazepam, 25 mg promethazine, and 4 mg XR melatonin for nausea/heart meds. - **March 26:** 7:45 PM - 270 mg freebase DXM, 25 mg promethazine, weed; 8:10 PM - weed; 9:20 PM - night meds with two pressed bars; 11:53 PM - 2 mg clonazepam sublingual. - **March 27:** Took 2 mg clonazepam around 12:40 AM after waking up unable to sleep; consumed 270 mg DXM, 25 mg promethazine, and 4 mg clonazepam and two pressed bars. - **March 28:** Four pressed bars; 10:25 PM - one pressed bar. - **March 29:** White powder sold as speed (ineffective), ketamine, weed, and two pressed bars. - **March 30:** Weed; 4:20 AM - ketamine; two pressed bars; ketamine in the afternoon (six lines); weed; ended up in ambulance respiratory arrest, administered narcan twice; two pressed bars. - **March 31:** One line of ketamine at 4:30 PM; 6:10 PM - two pressed bars and 270 mg DXM; 6:15 PM - weed. - **April 1:** 8:25 PM - four pressed bars. - **April 2:** Three lines of ketamine, two lines, two pressed bars, one line, and one pressed bar. - **April 3:** 1:32 AM - vodka Pepsi Max; 2:53 AM - one pressed bar; afternoon drinks at the pub (one double vodka, one cider); 9:30 PM - two pressed bars. - **April 4:** 1 PM - one pressed bar.
Answers (1)
4/4/2025, 2:40:55 PM
OpenHealth AI
I genuinely understand that you are feeling unwell and overwhelmed due to significant changes in your diet and ongoing substance use. Given your complex medical history and the symptoms you are experiencing, this is a situation that requires careful consideration. Let’s break down your main concerns and outline the best next steps.
Key Concerns:
- Recent Dietary Changes: Transitioning from a restrictive diet to binge eating can lead to physical and psychological discomfort, including symptoms like nausea, dizziness, and fatigue.
- Substance Use Complications: Your polysubstance use, combined with recent dietary changes, can affect your cardiovascular health, mental state, and overall well-being.
- Physical Symptoms: Experiencing chest pain, dizziness, and changes in heart rate/blood pressure can suggest serious underlying issues.
Explanation of Your Situation:
- Sudden changes in diet, particularly after a period of extreme restriction, can cause gastrointestinal distress and other metabolic issues. Binge eating can lead to symptoms like nausea, palpitation, and fatigue.
- The substance use you mentioned (including benzodiazepines and other drugs) can exacerbate physical symptoms and increase the risk of cardiovascular complications, especially given your history of tachycardia and cardiac symptoms.
- Your recent experiences, such as dizziness and temporary vision loss, are concerning and can indicate that your body is under stress, possibly from both dietary and substance shifts.
Next Steps:
-
Immediate Decision: Contact your general practitioner (GP) today. Given your symptoms and medical history, it is essential to speak with a healthcare professional to rule out any urgent concerns.
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Track Symptoms: Keep a log of your symptoms, noting when they occur and their severity. This information will be valuable for your GP.
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Stay Hydrated: Ensure you are drinking plenty of fluids, particularly water, to help your body recover from the recent dietary changes. Avoid alcohol and additional stimulants.
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Monitor Physical Symptoms: Regularly check your blood pressure and heart rate, and note any extreme changes. If any symptoms worsen (worsening chest pain, breathlessness, or extreme confusion), seek immediate medical help or go to the nearest emergency room.
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Consider a Support System: Reach out to someone who can support you through this period, whether a friend, family member, or a support group. You deserve care and assistance.
It’s brave of you to share your situation here, and I encourage you to take these steps seriously. Your health is important, and seeking help can lead you toward recovery. Please remember that you are not alone in this process, and professional support can make a significant difference.
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